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Flashcards in uncontrolled systemic inflammation Deck (19)
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What is the systemic response to a severe infection?

Cytokines and inflammatory mediators released into blood
Can lead to severe sepsis, septic shock, disseminated intravasular coagulation and multi-organ dysfunction syndrome


What are the criteria for Systemic inflammatory response syndrome (SIRS)?

Any of the following 2
Fever more than 38 or less than 36
HR higher than 90 BPM
Respiratory rate more than 20 breaths pm
PaCO2 less than 32 mmHg
Abnormal WBC count (>12,000 or <4,000)


What is a band cell?

Immature neutrophil


When would band cells appear in the blood?

When there is an inc need for neutrophils but its exceeds the bone marrow's ability to make them
Usually half formed


What is acute phase response?

Release of various proteins from liver in response to stimulation from IL-6 and other cytokines


What is sepsis?

SIRS due to documented infection


What is severe sepsis?

Sepsis with any sign of organ dysfunction


Define septic shock.

Infection-induced hypotension that is unresponsive to attempts at volume expansion (IV fluids)


What is disseminated intravascular coagulation (DIC)?

Systemic activation followed by depletion of clotting factors and subsequent hemorrhage


Define multi-organ dysfunction syndrome.

Varying degrees of organ impairment secondary to SIRS


What is compensatory anti-inflammatory response (CARS)?

Unregulated anti-inflammatory response leading to immune suppression and inc risk of infection


What is acute respiratory distress response (ARDS)?

Inflammation to the lungs
Inflam moderators cause inc vascular permeability and up-regulation of adhesion molecules
Fluid, protein and neutrophils leave lung and enter alveoli
Results in hypoxia and bilateral pulmonary infiltrates


What role does TNF-alpha play in sepsis/DIC?

Inc vascular permeability
Up-regulates adhesion molecules on endothelial cells
Induce expression of tissue factor on endothelial cells


What role does IL-1 play in sepsis/DIC?

Induce fever
Up-regulate adhesion molecules on endotheial cells


What role does IL-6 play in sepsis/DIC?

Release of acute phase proteins from liver
Induce expression of tissue factor on endothelial cells


C5a and C3a lead to release of mediators from ____.

Mast cells


System release of bacterial toxins and inflammatory mediators can lead to systemic inc in vascular permeability which in turns leads to;

Hypotension and pulmonary edema (ARDS)


What leads to activation of clotting systems?

Cytokines and endotoxins


If the system becomes hypotensive and clotting systems are activated what could that lead to?

Decreased organ perfusion (MODS) and ischemic necrosis (plague)